# ORAL FACIAL & IMPLANT SPECIALISTS, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659582062
- **Authorized official:** DR. MARTIN JAMES ZIDRON D.D.S. (PRESIDENT)
- **Authorized official phone:** (847) 381-0106

## Contact information

- **Practice address:** 21660 W FIELD PKWY, SUITE 220, DEER PARK, IL 60010-7265
- **Practice address phone:** (847) 381-0106
- **Practice address fax:** (847) 381-0265
- **Mailing address:** 21660 W FIELD PKWY, SUITE 220, DEER PARK, IL 60010-7265
- **Mailing address phone:** (847) 381-0106
- **Mailing address fax:** (847) 381-0265

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 060001824 | IL | Yes |

## Other

- **Enumeration date:** 05/25/2007
- **Last updated:** 07/24/2012